The parents of a 21-month-old boy have lost the latest stage of a fight to continue his life-support treatment.
A High Court judge has ruled that doctors can stop treating Alfie Evans, against the wishes of his parents Kate James and Tom Evans.
Three Court of Appeal judges upheld that decision on Tuesday.
Judges have heard that Alfie, who was born on May 9 2016, is in a "semi-vegetative state" and has a degenerative neurological condition doctors had not definitively diagnosed.
Mr Justice Hayden had analysed the case at hearings in the Family Division of the High Court in London and Liverpool.
Specialists at Alder Hey Children's Hospital in Liverpool said life-support treatment could stop and the judge said he accepted medical evidence which showed that further treatment was futile.
Alfie's parents, who are both in their 20s, challenged Mr Justice Hayden's ruling and asked the Court of Appeal to consider the case.
Lord Justice McFarlane, Lord Justice McCombe and Lady Justice King, who had examined issues at a Court of Appeal hearing in London on Thursday, dismissed the couple's challenge.
Alfie's parents were not at the appeal hearing in London but listened via a telephone link.
Barrister Stephen Knafler QC, who is leading Alfie's parents' legal team, said "the State" had wrongly interfered with "parental choice".
He said Alfie's parents wanted to move him to a hospital in Europe but Mr Justice Hayden's ruling had prevented them from doing that.